Intraoperative and Postoperative Complications Associated With Maxillary Sinus Augmentation

Maxillary sinus lift procedures are commonly used to augment bone in the posterior maxilla, with complication profiles varying according to surgical technique and patient- and site-related factors.

The study's purpose was to estimate the frequency of intraoperative and postoperative complications and identify associated risk factors in external and internal maxillary sinus lift procedures.

This retrospective cohort study was conducted at the Department of Periodontology, Gulhane Faculty of Dentistry, University of Health Sciences. Adult patients requiring maxillary sinus floor elevation via internal or external approaches were included based on residual bone height and radiographic availability. Exclusion criteria comprised systemic conditions affecting bone healing, heavy smoking, a history of sinus surgery or radiotherapy, and incomplete clinical records.

The primary predictor variable was the sinus lift technique (internal vs external). Additional predictors included patient-related, sinus- and site-related, and procedure-related factors.

The primary outcome variable was the occurrence of surgery-related intraoperative or postoperative complications (yes/no). Secondary outcomes included the types and frequencies of complications according to surgical technique.

Not applicable.

Statistical analyses included χ² tests, independent samples t tests, and binary logistic regression analyses to identify independent factors, with P < .05 considered statistically significant.

The cohort comprised 144 subjects (mean age, 49.0 ± 10.9 years), of whom 56.9% (n = 82) were women. Internal sinus lift was performed in 60.4% (n = 87) and external sinus lift in 39.6% (n = 57), with no significant age difference between groups (P = .2). Most subjects were systemically healthy 70.1% (n = 101), not using regular medication 72.2% (n = 104), and nonsmokers 91.0% (n = 131). Implant placement was achieved in 61.4% (n = 35). Sinus septa were present in 11.8% (n = 17), sinus pathology in 14.6% (n = 21), and bruxism in 22.9% (n = 33). Internal sinus lift was associated with a significantly lower overall complication rate than the external approach (P = .001).

Within the limitations of this retrospective study, internal sinus lift procedures were associated with fewer complications than external approaches, highlighting the importance of careful preoperative evaluation and appropriate technique selection.